| NPI | 1649958760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTIL WALLACE CEO 602-544-6832 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2023-12-11 |