| NPI | 1982996989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK GALLUS Chief Administrator 928-899-0128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: AZ 3273) |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2011-05-09 |