| NPI | 1275158719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER R. NASSER Owner 602-430-3705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 133N00000X Nutritionist | |
| 133V00000X Dietitian, Registered | |
| 163W00000X Registered Nurse | |
| 163WC0400X Registered Nurse, Case Management | |
| 163WP0808X Registered Nurse, Psych/Mental Health | |
| 164W00000X Licensed Practical Nurse | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 374U00000X Home Health Aide | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |