| NPI | 1538397567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARAS COLLUM Director 702-235-5650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: AZ BH-3341) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2009-06-29 |