| NPI | 1366028102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EZINNE IROKU CEO 602-877-8107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 251B00000X Case Management | |
| 261QH0100X Clinic/Center Health Service | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children | |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2023-01-12 |