| NPI | 1194186312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN TAYLOR Owner 602-228-1108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ CSLG7595) |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2016-03-16 |