| NPI | 1023823846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL DOBOS Administrator 602-512-5506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 2083A0300X Preventive Medicine, Addiction Medicine | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2025-02-10 |
| Last Update Date | 2025-02-10 |