| NPI | 1528846045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN CARLISLE Administrator 623-693-2198 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2024-06-20 |