NPI | 1629764816 |
---|---|
Doing Business As | WOODBRIDGE CAMPUS CRC |
Entity Type | Organization |
Authorized Contact | JANICE TALAS-DENNY Provider Network Management Assoc 602-416-7647 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2023-04-12 |
Last Update Date | 2023-04-12 |