| NPI | 1982359857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDINE KABONGO Authorized Official 480-474-6097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-02-18 |
| Last Update Date | 2022-02-18 |