| NPI | 1972146165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANCE MILLER CFO / Treasurer 928-718-4483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2024-01-18 |