| NPI | 1508942723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELLE LEVER Authorized Official 602-996-0110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH 2473) |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2023-03-07 |