| NPI | 1699369538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TLAHJONTE HOPSON Administrator 602-799-2757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 101Y00000X Counselor | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 103K00000X Behavior Analyst | |
| 106S00000X Behavior Technician | |
| 133V00000X Dietitian, Registered | |
| 163W00000X Registered Nurse | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| 172A00000X Driver | |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2022-07-25 |