NPI | 1619369394 |
---|---|
Entity Type | Organization |
Authorized Contact | MATT LUCHINI Insurance Administrator 928-533-4220 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2015-03-04 |
Last Update Date | 2015-03-04 |