| NPI | 1154508679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA A FORESTER Member 602-494-8105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AZ 3493) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2008-01-28 |