| NPI | 1336250190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM LACEY CEO/Administrator 520-417-2115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: AZ BH-2206) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |