| NPI | 1073004339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONA MEADOWS Administrator 928-634-7444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2023-04-10 |