| NPI | 1033817333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA EVANS Admin 602-526-0302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 251S00000X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 291U00000X Clinical Medical Laboratory | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2023-02-16 |
| Last Update Date | 2024-03-15 |