| NPI | 1053761197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BRUNSON Owner 602-358-4586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV 1588001937) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2016-06-20 |