NPI | 1033319751 |
---|---|
Other Name | CODAC 4TH AVENUE |
Entity Type | Organization |
Authorized Contact | W MARK CLARK CEO 520-327-4505 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
Enumeration Date | 2007-07-20 |
Last Update Date | 2008-02-15 |