| NPI | 1700966231 |
|---|---|
| Doing Business As | DIAMONDBACK LEVEL III GROUP HOME GIRLS |
| Entity Type | Organization |
| Authorized Contact | DAVID T BRADLEY CEO 520-750-9667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: AZ BH-1712) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |