| NPI | 1669041240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BENNETTI Executive Director 520-790-9144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2021-06-18 |
| Last Update Date | 2021-06-18 |