| NPI | 1003372491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC ANDREWS Director Of Quality Assurance 928-379-3097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2019-02-11 |