| NPI | 1497418115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY VINCENT BLOOM Chief Executive Officer 480-544-0283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2021-10-19 |