| NPI | 1679112619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA ROBINSON Executive Medical Director/COO 602-845-0767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TP0016X Psychologist, Prescribing (Medical) | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2019-12-21 |
| Last Update Date | 2020-06-19 |