| NPI | 1942042148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES AJASSI Administrator 480-235-8942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2024-06-10 |
| Last Update Date | 2024-06-10 |