| NPI | 1518395870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW LUCHINI Account Manager 928-533-4220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: AZ BH-3905) |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2013-10-24 |