| NPI | 1366030561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AYO AGORO Owner 623-600-8926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2021-01-04 |
| Last Update Date | 2021-01-04 |