| NPI | 1346533239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL DAVIS Member 520-488-7260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ LCSW-2701) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: AZ 1-09-5601) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2011-05-25 |