| NPI | 1063870061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY STRUVE Member 928-533-1034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2016-02-04 |
| Last Update Date | 2016-02-04 |