| NPI | 1578019741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHARINE RUSSELL Director 928-853-9843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-08-28 |