| NPI | 1336480037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE RENAUD CEO 602-258-6797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ OTC6180) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: AZ OTC-6180) |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2025-06-24 |