| NPI | 1104973288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE BROWN Training Coordinator 480-784-1514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ LPC-11726) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: AZ LISAC-10520) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |