| NPI | 1275942468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEOGRATIAS BARANSAKA Administrator 623-760-8378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ 851737) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2024-11-04 |