| NPI | 1780895102 |
|---|---|
| Doing Business As | COMMUNITY LIVING PROGRAM |
| Entity Type | Organization |
| Authorized Contact | KARMEN JOHNSON Associate Director 520-539-1263 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2024-06-20 |