| NPI | 1427502947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDUARDO SANTANA Supervisor 602-487-8806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ BH4514) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ BH4802) |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ BH4801) | |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2016-08-12 |