| NPI | 1851926166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISA DENEKE Administrator 623-670-0039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2020-03-06 |