| NPI | 1417519398 |
|---|---|
| Other Name | CHERRY LANE |
| Entity Type | Organization |
| Authorized Contact | SHAINA VAN PELT Director Of Operations 928-876-1153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2019-07-12 |