| NPI | 1588376875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY WADE Owner 623-980-7212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 172A00000X Driver |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2022-12-19 |