| NPI | 1245762087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVA YOLANDE HECTOR Administrator 602-218-8860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH5132) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH5132) |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2017-03-31 |