| NPI | 1376420596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY MARONEY Director 602-326-1828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 171M00000X Case Manager/Care Coordinator | |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| Enumeration Date | 2025-08-19 |
| Last Update Date | 2025-09-12 |