NPI | 1083102826 |
---|---|
Entity Type | Organization |
Authorized Contact | SARAH WICKLUND Medical Director 480-562-6600 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
Additional Taxonomies | 363A00000X Physician Assistant |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
261QM1300X Clinic/Center, Multi-Specialty | |
Enumeration Date | 2018-04-26 |
Last Update Date | 2021-04-21 |