| NPI | 1386077386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARISSE YOLLANDE KAMGAING Administrator 602-400-7764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: AZ BH4285) |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2013-08-13 |