| NPI | 1588380117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA DERY Owner 480-220-5864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2022-10-14 |
| Last Update Date | 2024-04-10 |