| NPI | 1639044647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE FARNEY Administrator 623-200-3267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2025-10-08 |
| Last Update Date | 2025-10-08 |