| NPI | 1417389958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELENE ROLLINS Member 480-921-0101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: AZ LCSW 0180) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2013-08-07 |