| NPI | 1467699777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMELIA IGNA Program Director/Administrator 623-879-0168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH-3092) |
| Additional Taxonomies | 251B00000X Case Management (Licence: AZ BH3092) |
| 251K00000X Public Health or Welfare (Licence: AZ BH3092) | |
| 251S00000X (Licence: AZ BH3092) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH3092) | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child (Licence: AZ BH3092) | |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2010-01-28 |