| NPI | 1134675077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIANA HERNANDEZ Administrator 602-380-8243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH4869) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-08-31 |