| NPI | 1619321908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR OKORIE Chief Executive Officer 602-441-2388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AZ BH4777) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-15037) |
| 101YP2500X Counselor, Professional (Licence: AZ LPC-13418) | |
| 103T00000X Psychologist (Licence: AZ 4010) | |
| 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-10962) | |
| 251S00000X (Licence: AZ CSLG7643) | |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2020-07-20 |