| NPI | 1588977920 |
|---|---|
| Former Legal Business Name | RESIDENTIAL TREATMENT FACILITY |
| Entity Type | Organization |
| Authorized Contact | MARY WAMBAIRE Program Director 520-248-1919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH3585) |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2010-07-14 |