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 Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2013-07-30 |
Last Update Date | 2023-01-04 |