| NPI | 1417406661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA GOMEZ Owner 602-618-8024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ 20016299) |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2016-09-29 |