| NPI | 1679793301 |
|---|---|
| Other Name | CODAC RECOVERY BRIDGE/ NORTH |
| Entity Type | Organization |
| Authorized Contact | W. MARK CLARK CEO 520-327-4505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: AZ BH-2543) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2008-02-15 |