| NPI | 1487391603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORINA OGAZ Associate Director, Credentialing 602-636-3085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2022-05-18 |