| 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 |