| NPI | 1154798023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETRA E PEPER Owner 602-510-6755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2015-08-27 |
| Last Update Date | 2016-04-25 |