| NPI | 1598368714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ANN TELLEZ Owner 602-313-9448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2020-11-19 |