| NPI | 1912746462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALI PETERSON Member 928-231-4731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-05-23 |
| Last Update Date | 2024-05-23 |