| NPI | 1629788559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WELLENGTEN JENKINS Director 602-421-6661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 177F00000X Lodging |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 251B00000X Case Management | |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2022-12-01 |