| NPI | 1174979603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN J DE JESUS Owner 480-375-1317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AZ 16081) |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2016-05-13 |