| NPI | 1649722000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS JAVIER VILLICANA Owner/President 623-248-1162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 251B00000X Case Management | |
| 251S00000X | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2024-04-11 |