| NPI | 1093399479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA JAMES LESLIE Administrator 623-300-5477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry | |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2023-05-04 |