| NPI | 1679025936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY RAE SCHRUNK Manager 801-376-6298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ LCSW-16391) |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2017-03-13 |