| NPI | 1407679897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERSON OLSON CEO/Administrator 602-616-0266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-11-04 |
| Last Update Date | 2024-11-04 |