| NPI | 1376367169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR WOOD Administrator 623-256-4184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2024-11-09 |
| Last Update Date | 2024-11-09 |