| NPI | 1669128609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FADHI HERSI Owner 602-688-9942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-02-28 |
| Last Update Date | 2025-04-13 |