| NPI | 1154592707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA TERESA ORNELAS Administrator 623-939-6567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH2882) |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2008-03-21 |