| NPI | 1396991758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMAR CLESTE THOMAS Owner 623-772-5408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ 3083) |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2008-08-15 |