| NPI | 1932643327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA HENNIGAN Speech Language Pathology Assistant 951-285-8091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: AZ SLPA10281) |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2016-12-05 |