| NPI | 1457421604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN FAHERTY Office Manager 480-963-3634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 251C00000X |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2022-07-21 |