| NPI | 1245999671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC GLADE MAUGHAN Adminsitrator 602-292-2010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0400X Clinic/Center Rehabilitation |
| Enumeration Date | 2021-12-13 |
| Last Update Date | 2022-09-15 |