| NPI | 1477973170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT PAYNE RICHARD Certified Professional Counselor 480-209-1977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: AZ CSLG7734) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ LISAC-10360) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2017-03-08 |