| NPI | 1902613888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED KALLE Administrator 602-884-3162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-12-14 |
| Last Update Date | 2024-12-17 |