| NPI | 1013602374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HABTOM H HADISH Manager 602-516-4473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2023-04-11 |