| NPI | 1518142033 |
|---|---|
| Doing Business As | FAIRVIEW LII GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | DAVID BRADLEY CEO 520-750-9667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: AZ BH3029) |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2008-01-03 |