| NPI | 1942821723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONYA WHITAKER Owner 623-562-0128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-05-02 |
| Last Update Date | 2020-05-02 |