| NPI | 1346954112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA GRACE FORRESTER Owner 480-296-9314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 310500000X Intermediate Care Facility, Mental Illness |
| Enumeration Date | 2023-01-06 |
| Last Update Date | 2023-02-01 |