| NPI | 1285340547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAYDEN WON MIN PHILLIP DUFF Owner 480-466-4837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261Q00000X |
| 261QM0801X | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2023-01-30 |
| Last Update Date | 2024-03-01 |