| NPI | 1235569328 |
|---|---|
| Doing Business As | CODAC AT DESERT LIFE |
| Entity Type | Organization |
| Authorized Contact | DENNIS REGNIER CEO 520-327-4505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AZ CSLG7120) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2015-09-25 |