| NPI | 1659230902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIAH WOODRUFF Owner 480-603-8905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-01-21 |
| Last Update Date | 2026-07-31 |