| NPI | 1356768089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MONROE COO 602-550-2211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CA 190810AP) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2017-07-28 |