| NPI | 1548140031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NASSON NATHAN Administrator 480-868-3177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-09-04 |
| Last Update Date | 2025-09-04 |