NPI | 1689194151 |
---|---|
Entity Type | Organization |
Authorized Contact | CINDY GAITHER VP Revenue Cycle Mgmt 602-248-8886 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: CFN1000021) |
Additional Taxonomies | 251S00000X |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
Enumeration Date | 2017-06-26 |
Last Update Date | 2024-02-10 |