| NPI | 1255998654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BREEDLOVE Authorized Official 480-840-1601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2019-05-22 |