| NPI | 1265967012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEY BRADLEY Administrator 623-414-0536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2017-04-28 |