NPI | 1528660388 |
---|---|
Entity Type | Organization |
Authorized Contact | CORINA OGAZ Associate Director, Credentialing 602-636-3085 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Additional Taxonomies | 261QM0801X |
Enumeration Date | 2020-11-16 |
Last Update Date | 2023-06-29 |