| NPI | 1588324438 |
|---|---|
| Doing Business As | NIDAA BEHAVIORAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | NGOZIKA VIVIAN AMENE Administrator 480-799-4806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-12-20 |
| Last Update Date | 2024-09-16 |