| NPI | 1104365287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN BYNUM Executive Director 602-249-6674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ BH3285) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ BH3285) |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2017-02-22 |