| NPI | 1477270098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIANNA CANN Administrator 520-840-3182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-10-24 |
| Last Update Date | 2022-10-24 |