| NPI | 1255999819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MBONG JERRY NGWESE Program Director 480-233-9241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2019-05-30 |