| NPI | 1609556927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PADRES JOELLE DOUNTIO TADA Administrator 480-370-1815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2023-07-20 |