| NPI | 1609198571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN M SUPPLEE Director/Owner 520-826-2206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ CSA09ADHS0188) |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2010-02-19 |