| NPI | 1326572397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ADAM THIELE CEO/Owner 602-277-2112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ CSLG8115) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: AZ CSLG8127) |
| 251S00000X Community/Behavioral Health (Licence: AZ CSLG8117) | |
| 251S00000X Community/Behavioral Health (Licence: AZ CSLG8126) | |
| 251S00000X Community/Behavioral Health (Licence: AZ CSLG8116) | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2024-07-02 |