| NPI | 1205533247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUGUSTIN NTEZEYOMBI CEO 480-845-3154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2023-02-16 |