| NPI | 1316718406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A THIELE CEO/Owner 602-277-2112 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2024-01-09 |
| Last Update Date | 2024-01-10 |