| NPI | 1255856704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLETTE RICHARDS Owner 602-288-8883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: AZ LPC-16260) |
| Enumeration Date | 2017-08-06 |
| Last Update Date | 2017-08-06 |