| NPI | 1518150317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA G VACCARO Owner 928-636-7890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ LCSW10904) |
| Enumeration Date | 2007-08-24 |
| Last Update Date | 2008-04-20 |