| NPI | 1710284716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUDY VEGA Owner 602-298-2540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH4149) |
| Additional Taxonomies | 3104A0630X Assisted Living Facility Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2022-11-07 |