| NPI | 1609466085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA HUCKLEBERRY Owner 480-577-6887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2021-01-20 |
| Last Update Date | 2022-11-16 |