| NPI | 1619299054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANEL JEAN JOHNSIN Owner Director 602-770-3634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: AZ BH3487) |
| Enumeration Date | 2010-02-26 |
| Last Update Date | 2010-02-26 |