| NPI | 1205360153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY GAITHER VP Revenue Cycle Mgmt 602-248-8886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: ND 9003) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 9003) |
| 251S00000X | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2024-05-29 |