| NPI | 1497448161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO F GOMEZ Owner 480-259-8998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2023-07-18 |