| NPI | 1548959836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIUP ALEXANDER KIM Authorized Official 480-323-6072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202D00000X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2023-09-06 |