| NPI | 1255035119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAT BOULAY Owner 602-816-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2023-03-27 |