| NPI | 1497436448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS NASSER-TAYLOR Co Owner 602-419-5244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2023-07-31 |