| NPI | 1215164421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK LAZARE Clinical Director/Owner 602-633-6000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2009-06-15 |