| NPI | 1467689455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK LAZARE Clinical Director 602-633-2000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH3143) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2009-06-17 |