| NPI | 1588467583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY VICARIO Administrator 623-215-1212 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 251B00000X Case Management |
| 261QH0100X Clinic/Center Health Service | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2025-03-27 |
| Last Update Date | 2025-06-16 |