| NPI | 1649895129 |
|---|---|
| Former Legal Business Name | GREAT FOR SPORTS |
| Entity Type | Organization |
| Authorized Contact | JOSEPH RASMUSSEN Executive Financial Officer 602-561-7491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |