| NPI | 1851926661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIE KWI Program Director 602-718-4018 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2020-03-12 |