| NPI | 1053008870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMITY AKOI Administrator 602-860-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 106S00000X Behavior Technician | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2023-04-21 |
| Last Update Date | 2023-04-21 |