| NPI | 1730908047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALI PETERSON Executive Director 928-231-4731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-10-04 |
| Last Update Date | 2026-01-07 |