| NPI | 1598235665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN POTHIER Owner 602-501-8097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2018-11-30 |