| NPI | 1750695870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAREE A JONES Office Manager 928-763-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ 3777) |
| Enumeration Date | 2010-07-30 |
| Last Update Date | 2010-07-30 |