| NPI | 1144564071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY GAITHER VP Of Revenue Cycle 602-248-8886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: OH 13361) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2024-02-09 |