| NPI | 1659571149 |
|---|---|
| Doing Business As | CODAC RECOVERY SUPPORT CENTER |
| Entity Type | Organization |
| Authorized Contact | W. MARK CLARK CEO 520-327-4505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AZ CSA06ADHS0194 1) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2007-07-23 |