| NPI | 1801369632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES GUAJARDO Manager 480-384-0789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2019-01-03 |