| NPI | 1164055026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDIRAZAQ IBRAHIM Owner 602-323-4873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2020-02-19 |