| NPI | 1245767052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE WILLIAMS Claims Mgr 520-526-1028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: AZ BH5118) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2019-06-14 |