| NPI | 1881878460 |
|---|---|
| Other Name | KAITLIN RANCH |
| Entity Type | Organization |
| Authorized Contact | THOMAS W KENNY CEO 928-526-0779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ DDH1715) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2007-12-19 |