| NPI | 1124372099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMARA BLACKMAN CEO/Director 602-795-5722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 101YP2500X Counselor, Professional | |
| 102X00000X Poetry Therapist | |
| 103K00000X Behavior Analyst | |
| 171100000X Acupuncturist | |
| 171M00000X Case Manager/Care Coordinator | |
| 172V00000X Community Health Worker | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| 261Q00000X Clinic/Center | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QR1100X Clinic/Center, Research | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2012-10-31 |