| NPI | 1962968438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERGE N SANDRALI Manager 480-938-6189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-02-20 |