| NPI | 1619202074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM HANSEN Administrator 926-271-5550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: AZ BH-3409) |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2009-10-02 |