| NPI | 1285237859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IHEANYI AMANWANNE CEO 623-206-8074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| 283Q00000X Psychiatric Hospital | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2020-11-17 |
| Last Update Date | 2022-11-07 |