| NPI | 1669986998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OCEAN WOLPERT Administrator 602-732-1151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QR0800X Clinic/Center, Recovery Care |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YP2500X Counselor, Professional | |
| 106H00000X Marriage & Family Therapist | |
| 133N00000X Nutritionist | |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 164X00000X Licensed Vocational Nurse | |
| 261Q00000X Clinic/Center | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2021-02-12 |