| NPI | 1356832067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMMIE BLACK Bht 623-213-7186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: AZ BH5425) |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2025-09-08 |