| NPI | 1205325198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH M. JOHANSEN Clinical Director 480-608-5250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AZ LPC-14026) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2025-10-13 |