| NPI | 1184102709 | 
|---|---|
| Other Name | EXTENSION SABG | 
| Entity Type | Organization | 
| Authorized Contact | CHRIS RILEY Executive Director 602-263-5242  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH-5467)  | 
| Enumeration Date | 2018-08-06 | 
| Last Update Date | 2025-06-05 |