| NPI | 1518644814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE JONES Adm 602-731-5188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2023-06-29 |
| Last Update Date | 2023-06-29 |