| NPI | 1841032208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANTREEL PATE Owner 480-799-7927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-06-07 |
| Last Update Date | 2024-06-07 |