| NPI | 1922463496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER TISDALE Owner 480-750-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2023-02-09 |