| NPI | 1639596927 | 
|---|---|
| Other Name | EAGLES NEST BOYS RESIDENTIAL AGENCY | 
| Entity Type | Organization | 
| Authorized Contact | TED D MCCLURE Executive Director 602-568-1441  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: DC BH4442)  | 
| Enumeration Date | 2014-03-25 | 
| Last Update Date | 2014-03-25 |