| NPI | 1770029340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN SOYARS Director 602-216-0518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ DDH1269) |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2023-07-28 |