| NPI | 1245504927 |
|---|---|
| Other Name | NONE |
| Entity Type | Organization |
| Authorized Contact | PATRICIA R. BRUCE Clinical Director 520-281-0009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW13060) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC10240) |
| 101YP2500X Counselor, Professional (Licence: AZ LPC11949) | |
| Enumeration Date | 2012-02-28 |
| Last Update Date | 2012-08-21 |