| NPI | 1245904283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE MCINTOSH Owner 480-288-1053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP1600X Counselor, Pastoral | |
| 101YP2500X Counselor, Professional | |
| 104100000X Social Worker | |
| 106S00000X Behavior Technician | |
| 251S00000X | |
| 251V00000X Voluntary or Charitable | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| Enumeration Date | 2021-08-03 |
| Last Update Date | 2024-05-17 |