| NPI | 1336888189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND SMITH Administrator 623-226-8191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106S00000X Behavior Technician | |
| 251B00000X Case Management | |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2022-05-31 |