| NPI | 1356780753 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | SHANA GOULET Director Of Operations 602-810-1210  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | 
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health | 
| Enumeration Date | 2013-06-19 | 
| Last Update Date | 2023-02-10 |