| NPI | 1538341458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA SUE HENLEYJOHNSON CEO 520-293-8085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: AZ BH-1285) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: AZ BH-1285) |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: AZ BH-339) | |
| Enumeration Date | 2007-12-03 |
| Last Update Date | 2009-04-15 |