| NPI | 1679346654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELEN DIKE Program Manager 602-489-8616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2023-11-01 |
| Last Update Date | 2023-11-01 |