| NPI | 1639490543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA DEGRANDIS Sole Member 480-385-8223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: KS T-LP 1878) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2010-06-15 |