| NPI | 1386102788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT K KOSKEI Healthcare Manager 602-516-9785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2019-03-05 |