| NPI | 1144382524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUSTAVO ALBERT RODRIGUEZ Clinical Liaison 928-376-0026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-1257) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-08-22 |