| NPI | 1013542778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAWNY RUNNELS Clinical Director 623-680-3469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2020-04-28 |