| NPI | 1639471139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARITY F BARKER Office Manager 928-754-1011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ AP1282) |
| Enumeration Date | 2010-12-03 |
| Last Update Date | 2010-12-03 |