| NPI | 1255617874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY L LOTT Executive Director 520-414-7465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2011-10-27 |