| NPI | 1740397058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOSHE LOBL Owner 602-800-6553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 385HR2055X Respite Care Respite Care, Mental Illness, Child (Licence: AZ BH-3633) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2024-08-01 |