| NPI | 1801500574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIANNA CANN Administrator 520-233-7581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2023-01-09 |