| NPI | 1073655544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER LOISELLE President 520-797-9306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ LISAC0936) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: AZ LCSW0812) |
| 1041C0700X Social Worker Clinical (Licence: AZ LCSW0813) | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |