| NPI | 1720735202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY BARRASSO COO 520-722-9631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2022-03-04 |
| Last Update Date | 2023-07-28 |