| NPI | 1619768603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNATHAN ANDERSON CEO 602-290-1681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2025-05-16 |
| Last Update Date | 2025-05-16 |