| NPI | 1821616319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELVINE MUTETERI Administrator 623-214-6420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2020-07-10 |