| NPI | 1548712730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK RYAN Therapist/Manager 602-391-3589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2016-11-04 |