| NPI | 1629477799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY V WESLEY Owner 602-397-9737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2014-08-14 |