| NPI | 1386924371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONAH M GILLOOLY Ess Counselor 520-836-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AZ LCSW-12294) |
| Additional Taxonomies | 251S00000X (Licence: AZ LISAC-11537) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2011-08-22 |