| NPI | 1366807596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA FONTAINE Owner 480-987-6529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 10622) |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2015-12-14 |