| NPI | 1407028145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO CONTRERAS Owner 928-783-1505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH-2994) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2008-04-01 |