| NPI | 1306485107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DICKSON KWARTENG Administrator 623-200-6017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2019-12-27 |