| NPI | 1376072884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARB DAVIS Billing Manager 602-697-3488 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ OTC8039) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-07-21 |