| NPI | 1730375668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLA C HATCH Executive Director 928-229-0560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2011-03-15 |