| NPI | 1225632565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETCHEN ELIZABETH HERNDON Counselor 928-503-1827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-11-27 |
| Last Update Date | 2020-11-27 |