| NPI | 1205208865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | H. RANDALL CRAIG Manager 480-788-3107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0800X Clinic/Center, Recovery Care |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| 261QR1100X Clinic/Center, Research | |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2015-10-22 |