| NPI | 1740532118 |
|---|---|
| Doing Business As | MOUNTAIN HOME |
| Entity Type | Organization |
| Authorized Contact | CHRIS BANKEN Sr. Vice President Of Operations 602-335-2095 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2012-10-10 |