NPI | 1639983075 |
---|---|
Other Name | NONE |
Entity Type | Organization |
Authorized Contact | CASSANDRA OLIVER Owner 623-221-2252 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
Enumeration Date | 2025-02-05 |
Last Update Date | 2025-02-05 |