| NPI | 1396597753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHALINA MITCHELL Owner 602-502-6238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children | |
| 101Y00000X Counselor | |
| 163W00000X Registered Nurse | |
| 251B00000X Case Management | |
| 251K00000X Public Health or Welfare | |
| 251S00000X Community/Behavioral Health | |
| 261QH0100X Clinic/Center Health Service | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-04-02 |