| NPI | 1346659554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC MARINELLI Facilty Coordinator 928-642-3346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: AZ 46880) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2022-03-14 |