| NPI | 1679340046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INA JEAN HAYES Owner 602-921-1166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2023-12-06 |
| Last Update Date | 2023-12-06 |