| NPI | 1659961639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ODETTE MUBALAMA CEO 602-888-6779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 261QS1200X Clinic/Center, Sleep Disorder Diagnostic | |
| Enumeration Date | 2021-01-22 |
| Last Update Date | 2021-01-22 |