| NPI | 1730949587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCIUS KING Owner 480-416-9691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2024-03-20 |