| NPI | 1518365386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZEITUNI JELAGAT KIPROTICH Administrator 623-755-4931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH4511) |
| Enumeration Date | 2014-12-10 |
| Last Update Date | 2014-12-10 |