| NPI | 1518550987 |
|---|---|
| Other Name | PHOENIX SUBSTANCE USE DISORDER RECOVERY SERVICES |
| Entity Type | Organization |
| Authorized Contact | ERICA OCHOA Chief Compliance Officer 909-388-0879 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2021-02-17 |
| Last Update Date | 2022-09-07 |