| NPI | 1225451453 |
|---|---|
| Other Name | ETHAN ORR |
| Entity Type | Organization |
| Authorized Contact | JEREMIAH LOPEZ Program Director 520-275-5927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2014-01-23 |
| Last Update Date | 2014-01-23 |