| NPI | 1548968274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FESTUS UBIEBOR Program Manager 602-931-7437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-02-22 |
| Last Update Date | 2023-02-24 |