| NPI | 1215432331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE SOUTHWICK Owner 480-744-5864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ LPC-17009) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2018-03-29 |