| NPI | 1083432686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANN SMITH Business Manager 602-492-7632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2024-12-22 |