| NPI | 1902142565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN DI SIMONE Accounts Manager 928-708-9615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: AZ BH-4143) |
| Enumeration Date | 2012-12-28 |
| Last Update Date | 2012-12-28 |