| NPI | 1487312302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLEQ P MASTERSON Member Of LLC, Owner, Physician 520-229-0585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2021-12-08 |
| Last Update Date | 2021-12-08 |