| NPI | 1639956436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS ERNEST KONYI KOMETA Director 480-252-3484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2023-09-13 |
| Last Update Date | 2023-09-13 |