| NPI | 1659561637 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ADELLA CORDOVA Practice Administrator 623-326-1055  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AZ 30033)  | 
| Enumeration Date | 2007-07-26 | 
| Last Update Date | 2008-07-29 |