| NPI | 1710267968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA MARIE GANAGO Owner/Operator 520-551-0643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH-3896) |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2016-06-23 |