| NPI | 1548707748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY GAITHER VP Of Revenue Cycle 480-935-5755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: IN 1522-5-OTF) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251S00000X Community/Behavioral Health (Licence: IN 1522-0-ASR) | |
| 261QM0801X | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2024-02-09 |