| NPI | 1295119105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK LAWRENCE Manager 602-625-5808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: AZ BH-4101) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2015-07-10 |