| NPI | 1700383411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTOPHER DOHSE Manager 928-864-5024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AZ 15628) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2022-11-11 |