| NPI | 1427447333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PASCAL AMINKENG ETIENDEM Assistant Administrator 520-981-5227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH4550) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2015-01-15 |