NPI | 1841839727 |
---|---|
Entity Type | Organization |
Authorized Contact | CORNELIUS TANYIKO Administrator 480-295-5482 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Enumeration Date | 2019-12-25 |
Last Update Date | 2019-12-25 |