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 |