| NPI | 1437963733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN T CHACKO Nurse Practitioner 480-719-0098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-02-05 |
| Last Update Date | 2025-02-05 |