| NPI | 1649917238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENRIC JOHN BALORIA Owner 623-455-1194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2022-05-16 |