| NPI | 1639065402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHIEKA HENDERSON BIRKS CEO 480-202-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| 311Z00000X Custodial Care Facility | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 332U00000X Home Delivered Meals | |
| 347C00000X Private Vehicle | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2025-06-17 |
| Last Update Date | 2025-06-17 |