| NPI | 1417330655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A. WATTS Chief Administrative Officer 928-287-3957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ OTC-6458) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2015-07-07 |