| NPI | 1568161800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD STODDARD CEO 480-330-3138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2023-11-06 |