| NPI | 1689352866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS ERNEST KONYI KOMETA Director 480-252-3484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-07-07 |
| Last Update Date | 2023-08-21 |