| NPI | 1033697818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE WILLIAMS Claims Mgr 520-526-1028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ IFBH8264) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: AZ OTC8336) |
| 251S00000X Community/Behavioral Health (Licence: AZ BH5118) | |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2019-07-03 |