| NPI | 1629560941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LACY Executive Director 480-339-7119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MED7600) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2024-07-12 |