| NPI | 1649403544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE PACKARD Partner 928-773-7774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: AZ 3125) |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2009-08-26 |