| NPI | 1356096036 |
|---|---|
| Other Name | GROUP ID |
| Entity Type | Organization |
| Authorized Contact | JANICE TALAS-DENNY Provider Network Managment Assoc 623-273-6154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2022-02-21 |
| Last Update Date | 2023-03-03 |