| NPI | 1003150202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW LUCHINI Accounts Manager 928-533-4220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA NT00001624) |
| Enumeration Date | 2012-11-12 |
| Last Update Date | 2012-11-12 |