| NPI | 1518061779 |
|---|---|
| Other Name | 0 |
| Entity Type | Organization |
| Authorized Contact | WILLIAM GARY STEWART Social Worker 502-682-4111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AZ LCSW98I) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2020-08-22 |