| NPI | 1972849149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GURR Program Director 928-567-1322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: AZ LPC12646) |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2012-12-17 |