| NPI | 1336904168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY LIVINGSTON VP Of Revenue Cycle 602-256-3020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2024-02-20 |
| Last Update Date | 2024-02-20 |