| NPI | 1821509647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LARIMER Program Director 602-300-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2017-10-19 |