| NPI | 1679301659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SULEMAN SIDDIQUI Owner 623-703-1487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-07-23 |
| Last Update Date | 2024-07-23 |