| NPI | 1144799792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ROSS CEO 480-516-8037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 101YP1600X Counselor, Pastoral | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 133N00000X Nutritionist | |
| 183500000X Pharmacist | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2021-04-14 |