| NPI | 1720452543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BASHA Manager 480-848-4281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: AZ 6944) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ 6944) |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2015-12-18 |