| NPI | 1659191781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIGUEL BUSTOS Owner 623-552-8301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Additional Taxonomies | 251S00000X |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2024-10-14 |
| Last Update Date | 2024-10-29 |