| NPI | 1912652652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEKOU JACKSON Program COO Rdinator 623-293-7792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-02-21 |
| Last Update Date | 2022-02-21 |