| NPI | 1457107047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEKOU JACKSON Administrator 623-293-7792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2024-04-25 |
| Last Update Date | 2024-04-25 |