| NPI | 1629738901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IAN DY Statutory Officer 480-280-8690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2021-12-28 |
| Last Update Date | 2021-12-28 |