| NPI | 1588764427 |
|---|---|
| Other Name | PROVIDENCIA |
| Entity Type | Organization |
| Authorized Contact | DAVID HEDGCOCK Executive Director 602-455-4626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AZ BH-2200) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2020-08-22 |