| NPI | 1912423732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOSHE E LOBL Owner 602-800-6553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385HR2055X Respite Care, Respite Care, Mental Illness, Child (Licence: AZ 5175) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2025-03-18 |