| NPI | 1457078347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL BANGURA Coe/Adminstration 623-216-5759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-10-21 |
| Last Update Date | 2024-07-02 |