| NPI | 1245719236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS ANN GROSSMAN Administrative Director 602-410-6635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2022-08-11 |