NPI | 1538672076 |
---|---|
Doing Business As | MARTHA'S RESIDENTIAL CARE LLC - FAIRMOUNT HOUSE |
Entity Type | Organization |
Authorized Contact | SAFFIATU S TUNIS Program Director 623-271-8248 |
Organization Subpart ? | Yes |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH5302) |
Enumeration Date | 2017-11-07 |
Last Update Date | 2017-11-07 |