| NPI | 1316179138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY ROOP CFO 520-750-9667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: AZ BH-3388) |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2009-08-12 |