| NPI | 1528822350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILDINE BURGESS Exec Admin 602-354-9252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103T00000X Psychologist | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-02-12 |
| Last Update Date | 2024-02-12 |