| NPI | 1568592640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA BETH GOMEZ Professional Foster Parent 602-299-5965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: AZ 11078) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2008-06-27 |