| NPI | 1326618521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINO CRUSE Owner 480-749-2392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2021-06-29 |