| NPI | 1326246067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRENCE HICKS Owner 623-537-7195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2022-07-21 |