| NPI | 1568863322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE E JACKSON CEO 928-649-6736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 46710) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2014-10-14 |