NPI | 1437346517 |
---|---|
Doing Business As | DBA: MAVERICK HOUSE |
Entity Type | Organization |
Authorized Contact | EDWARD WILLIAM PINNOW Acting Director 623-937-9203 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: AZ BH 406) |
Enumeration Date | 2007-10-02 |
Last Update Date | 2014-04-07 |