NPI | 1609639343 |
---|---|
Entity Type | Organization |
Authorized Contact | BRYAN LAZARO Administrator 602-888-3474 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2024-02-05 |
Last Update Date | 2024-02-05 |