| NPI | 1588727259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK TRAVIS CALLESEN President 480-464-4606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: AZ 23058) |
| Enumeration Date | 2006-12-17 |
| Last Update Date | 2020-08-22 |