| NPI | 1790509354 |
|---|---|
| Doing Business As | LWB HOLLY HOUSE |
| Entity Type | Organization |
| Authorized Contact | DANIEL GONZALEZ Chief Executive Officer 480-522-4268 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-11-11 |
| Last Update Date | 2025-09-22 |