| NPI | 1124555610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE AXLUND Chief Operating Officer 928-645-5113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ CSLG8261) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2022-07-21 |