NPI | 1467778654 |
---|---|
Entity Type | Organization |
Authorized Contact | CINDY GAITHER VP Revenue Cycle Mgmt 602-248-8886 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X (Licence: OH 12984) |
Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
Enumeration Date | 2010-04-13 |
Last Update Date | 2024-02-09 |