| NPI | 1699831123 |
|---|---|
| Other Name | AGL - COLUMBINE |
| Entity Type | Organization |
| Authorized Contact | ANNETTE INIGUEZ Exec Asst 602-285-0505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH2186) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2020-08-22 |