| NPI | 1245963610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL APPLETON Manager 602-618-3756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2022-07-05 |