| NPI | 1114462306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA LARSON-HUFFACKER Executive Director 480-784-1514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ OTC7842-5DUT11) |
| Enumeration Date | 2016-12-27 |
| Last Update Date | 2016-12-27 |