| NPI | 1427154368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH LYLE FOX Executive Director 602-265-9987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: AZ BH 1611) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2020-08-22 |