| NPI | 1235562463 |
|---|---|
| Former Legal Business Name | ALPHA OMEGA PCCS, LLC |
| Entity Type | Organization |
| Authorized Contact | ROXANNE DALPOS Clinical Director 480-203-8414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AZ LPC13318) |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2019-09-04 |