| NPI | 1548785884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN OMIJIE Program Director 623-326-3327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ BH5219) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2022-07-21 |