| NPI | 1275206575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEOPHILUS FABULUJE Executive President 602-488-8596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 253J00000X Foster Care Agency |
| 253Z00000X In Home Supportive Care | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 310400000X Assisted Living Facility | |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 385H00000X Respite Care | |
| 385HR2050X Respite Care, Respite Care Camp | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251E00000X Home Health | |
| Enumeration Date | 2021-08-01 |
| Last Update Date | 2025-05-13 |