| NPI | 1124440375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW LUCHINI Account Manager 928-533-4220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2014-01-07 |
| Last Update Date | 2014-01-07 |