| NPI | 1609511369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WELLENGTEN JENKINS Managing Partner 602-421-6661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QR0800X Clinic/Center, Recovery Care |
| 253Z00000X In Home Supportive Care | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 251B00000X Case Management | |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2022-04-28 |