| NPI | 1396413720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED OTHMAN Owner 602-815-3293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2022-08-16 |