| NPI | 1659722114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY GAITHER VP Revenue Cycle Mgmt 602-248-8886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center Methadone (Licence: AK 1036521) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AK 1036521) |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: AK 1036521) | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2024-07-15 |