| NPI | 1659608123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK HALLBACK Managing Director / Owner 602-794-7695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ 445542) |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2011-12-29 |