| NPI | 1548817497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAETAN KAYITANKORE Administrator 520-339-7853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2019-08-23 |