| NPI | 1265871644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW LUCHINI Account Manager 928-533-4220 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2013-06-19 |