| NPI | 1609075480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE KURT MOORE Owner 480-218-1949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: AZ 2943) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2007-07-12 |