| NPI | 1982894036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA TILLMAN President 928-445-3834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: AZ BH3230) |
| Additional Taxonomies | 261QR0800X Clinic/Center Recovery Care (Licence: AZ BH2563) |
| 276400000X Rehabilitation, Substance Use Disorder Unit (Licence: AZ BH3230) | |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2017-02-09 |