| NPI | 1548914534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASIA MONDAE MILLER Administrator 602-675-1289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2022-02-08 |