| NPI | 1215263314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA TILLMAN President 928-776-3073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: AZ BH3230) |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit (Licence: AZ BH3230) |
| Enumeration Date | 2009-10-23 |
| Last Update Date | 2009-10-23 |