| NPI | 1851103451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEE LAUREN KIDDE Owner 602-571-8563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| Enumeration Date | 2025-01-22 |
| Last Update Date | 2025-01-22 |