| NPI | 1992330104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL OWUSU-AKYEAW Administrator 480-616-0133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2024-05-20 |