| NPI | 1013788744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE PASQUERELLO Clinical Supervisor 602-862-8926 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-01-11 |
| Last Update Date | 2024-01-11 |