| NPI | 1245679620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON BIRDELL GROSSMAN President/Executive Director 602-410-6637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: AZ BH4275) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2022-08-11 |