| NPI | 1568179679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | USIBONGE MULUMBI Program Director 623-900-8607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2022-10-31 |