| NPI | 1497538243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY E NGALLE Owner 602-775-0609 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2023-08-16 |
| Last Update Date | 2023-08-16 |