| NPI | 1447990619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS NASSER-TAYLOR Co Owner 602-318-4571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2025-01-06 |