| NPI | 1205507563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FLORA ISSANDA STOWATER Administrator 480-840-4777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-09-25 |
| Last Update Date | 2022-12-06 |