| NPI | 1508092776 |
|---|---|
| Other Name | AGL - CANYON |
| Entity Type | Organization |
| Authorized Contact | ANNETTE M INIGUEZ Executive Assistant 602-285-0505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH3294) |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2009-08-26 |