NPI | 1114309945 |
---|---|
Entity Type | Organization |
Authorized Contact | CLINT RICHARDS Program Director 928-237-9378 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
Enumeration Date | 2015-06-29 |
Last Update Date | 2015-06-29 |