| NPI | 1164694170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY DOZORETZ Regional Director 520-320-4039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH-2689) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2008-03-31 |