| NPI | 1962152280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYNE DUSABE Of 623-248-8548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2022-03-28 |