| NPI | 1619482478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER MICHAEL BRADSHAW CEO, Provider 602-733-0584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 202D00000X Integrative Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2017-12-02 |
| Last Update Date | 2024-01-04 |