| NPI | 1750002291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN STUART Ur 623-332-3738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-09-02 |
| Last Update Date | 2022-09-02 |