| NPI | 1720595879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCY MEVORACH Sole Member 480-707-2885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2018-01-10 |