| 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 |