| NPI | 1639771496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORINA OGAZ Associate Director, Credentialing 602-636-3085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2023-06-29 |