| NPI | 1750745196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GABRIEL CARDOSO Director 602-400-2288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ bh4530) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2016-04-12 |