| NPI | 1093500670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEATRICE EKO Administrator 602-612-3124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| Enumeration Date | 2025-04-14 |
| Last Update Date | 2025-04-14 |