| NPI | 1417639949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL OMAR FERNANDEZ Administrator 602-314-4745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| 106S00000X Behavior Technician | |
| 251B00000X Case Management | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2023-08-03 |
| Last Update Date | 2025-07-22 |