| NPI | 1508212580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARISSE KAMGAING CEO, Administrator 602-400-7764 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ bh4892) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ bh4891) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-05-10 |