| NPI | 1467293357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY RASMUSSEN Credentialing Coordinator 480-784-1514 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-06-04 |
| Last Update Date | 2024-06-04 |