| 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 |