| NPI | 1134908015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNA EISENDRATH License Clinical Social Worker 928-862-8689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-09-28 |
| Last Update Date | 2023-09-28 |