| NPI | 1770299752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAXANDRA M PAIN Member, Bht 520-519-9465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2023-01-24 |
| Last Update Date | 2023-03-14 |