| NPI | 1629474481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CARLTON Medical Director 480-998-4673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: AZ OTC6845) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: AZ OTC6845) |
| Enumeration Date | 2014-11-06 |
| Last Update Date | 2014-11-06 |