| NPI | 1538892856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENRIC JOHN BALORIA Administrator 623-455-1194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2022-07-05 |