| NPI | 1558742627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORINA OGAZ Associate Director, Credentialing 602-636-3085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL-109103) |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 283Q00000X Psychiatric Hospital (Licence: MHL-109103) | |
| 283Q00000X Psychiatric Hospital | |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2022-06-21 |