| NPI | 1417755026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERILYN THAC Owner 480-275-1056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2025-03-07 |
| Last Update Date | 2025-03-07 |