| NPI | 1245041813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY KNUDSON Member 480-269-7906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2025-01-14 |
| Last Update Date | 2025-04-24 |