| NPI | 1629430459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDETTE E WAITE Owner 602-550-5221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ LPC15820) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2018-03-17 |