| NPI | 1255202354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TENEMA MASSAQUOI Owner 480-708-8512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-09-13 |
| Last Update Date | 2025-09-15 |