| NPI | 1578853735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY LOU TATUM-SHIPLEY Executive Director 623-876-2029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ BH-3654) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ BH-3564) |
| 101YP2500X Counselor Professional (Licence: AZ BH-3654) | |
| 1041C0700X Social Worker Clinical (Licence: AZ BH-3654) | |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2011-04-08 |