| NPI | 1235420357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTI L DAVIS Owner 6233-980-8904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ 13568) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 10498) |
| Enumeration Date | 2011-04-23 |
| Last Update Date | 2012-01-20 |