| NPI | 1659760213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVA A HERNANDEZ Licensing & Credentialing Manager 602-285-4330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2015-01-20 |