| NPI | 1417468398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CARDOSO Program Director / Owner 602-400-2288 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AR BH5158) |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2017-10-18 |