| NPI | 1568235224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELSIE KALULE Owner 602-486-4328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2023-11-03 |
| Last Update Date | 2025-01-24 |