| NPI | 1659911576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MUNYAO KIVILA Administrator 480-634-5485 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2020-01-08 |