| NPI | 1093240020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EILEEN M JACOBSON Director Health Info Mgmt/Complianc 520-743-2162 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: AZ OTC7911) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: AZ OTC7911) |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2017-04-27 |