| NPI | 1548692742 |
|---|---|
| Former Legal Business Name | AGAVE FAMILY SERVICES LLC |
| Entity Type | Organization |
| Authorized Contact | JONATHAN CHARLES MACKEY Owner/ Clinical Social Worker 480-779-9050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2023-01-04 |