| NPI | 1669117206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCA MCCALLIE President 928-606-2907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103T00000X Psychologist |
| 261Q00000X Clinic/Center | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2025-04-22 |