| NPI | 1710532676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATIA WALSH Administrator 602-622-7347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2019-08-07 |