| NPI | 1336602788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | USMAN J BUNDU Program Director 480-977-9457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2019-04-12 |