| NPI | 1306585666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONELLE DONGMO Program Director/Administrator 602-465-2569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-06-03 |
| Last Update Date | 2022-06-03 |