| NPI | 1750089637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALINE SHADYNE MAHORO CEO 602-524-4066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2023-06-13 |