| NPI | 1639531072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE HORTENSE TIOKOU Administrator 480-616-3858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: AZ BH4783) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2018-10-11 |