| NPI | 1174211007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIASHEN MOODLEY Administrator 623-703-9840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor Mental Health | |
| 106S00000X Behavior Technician | |
| 171M00000X Case Manager/Care Coordinator | |
| 174400000X Specialist | |
| 207R00000X Internal Medicine | |
| 208D00000X General Practice | |
| 405300000X Prevention Professional | |
| 202D00000X | |
| 207Q00000X Family Medicine | |
| 207QA0000X Family Medicine Adolescent Medicine | |
| 207QA0401X Family Medicine Addiction Medicine | |
| 207QA0505X Family Medicine Adult Medicine | |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2023-04-27 |