| NPI | 1871366658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAUD BIOLA KOLEOSHO Medical Director 520-431-8744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2023-11-02 |