| NPI | 1710394614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE 0DONGO Member 602-903-9193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH 4444) |
| Enumeration Date | 2014-07-13 |
| Last Update Date | 2014-07-13 |