| NPI | 1366179236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORRELL OWENS Owner 602-690-2352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-08-02 |
| Last Update Date | 2022-08-02 |