NPI | 1578685822 |
---|---|
Entity Type | Organization |
Authorized Contact | MINDI A WOODRUFF Acting Secretary/Program Sponsor 480-981-1022 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ BH2631) |
Enumeration Date | 2007-04-06 |
Last Update Date | 2021-05-06 |