| NPI | 1851681118 |
|---|---|
| Doing Business As | ORIGINS |
| Entity Type | Organization |
| Authorized Contact | JAMES S. GITTINGS CEO 520-400-0987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ 06176) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2011-04-07 |