| NPI | 1366060477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE REED Statutory Agent 480-447-5588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2020-07-06 |