| NPI | 1134875727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA EVANS Administrator 602-526-0302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 251S00000X | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-02-23 |
| Last Update Date | 2022-08-10 |