| NPI | 1033448923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL R HANSEN Chief Executive Officer 928-446-8278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ LISAC-11869) |
| Enumeration Date | 2009-12-23 |
| Last Update Date | 2010-04-21 |