| NPI | 1063100949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE VICTORIA BOLTON Administrator 602-892-0633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2025-10-29 |