| 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 |