| NPI | 1144790031 |
|---|---|
| Doing Business As | PRODIGY HEALTHCARE |
| Entity Type | Organization |
| Authorized Contact | ADAM THARP President And COO 480-235-6760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2018-12-04 |