NPI | 1316440241 |
---|---|
Entity Type | Organization |
Authorized Contact | NICOLE PETERSON Billing Coordinator 520-441-4754 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ LCSW15769) |
Enumeration Date | 2018-03-16 |
Last Update Date | 2018-03-16 |