| NPI | 1013792118 |
|---|---|
| Former Legal Business Name | PARK PLACE RECOVERY AND WELLNESS CENTER LLC. |
| Entity Type | Organization |
| Authorized Contact | TARA L CHASE Therapist 623-462-8187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2023-08-28 |