| NPI | 1104173046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDMUNDO HIDALGO CEO 602-257-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH4031) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2012-10-10 |