| NPI | 1679995260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK THOMAS WESTBY Owner 520-280-8831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ LISAC-11886) |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2014-01-15 |