| NPI | 1487126686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAUSTIN BULONGO KAPELEMBA Co Owner 602-643-5723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2018-12-28 |