| NPI | 1285968024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAREE A JONES Business Office Administrator 928-763-4796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: AZ 1697) |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2009-09-28 |