| NPI | 1295621464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS LASSITER Managing Director 480-242-8539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| 101YM0800X Counselor Mental Health | |
| 103T00000X Psychologist | |
| 103TP0016X Psychologist Prescribing (Medical) | |
| 171400000X | |
| 251S00000X Community/Behavioral Health | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 364SP0807X Clinical Nurse Specialist Psychiatric/Mental Health, Child & Adolescent | |
| 364SP0810X Clinical Nurse Specialist Psychiatric/Mental Health, Child & Family | |
| Enumeration Date | 2025-06-16 |
| Last Update Date | 2025-06-17 |