| NPI | 1336607746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKY DRAMARETSKA Owner/Provider 480-300-6065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 251S00000X |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2021-06-17 |