| NPI | 1366103780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN AWOSIKA Owner/Administrator 480-494-1419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2022-01-07 |
| Last Update Date | 2022-01-07 |