| NPI | 1760735864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL C BRUBAKER Owner 520-836-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH-3333) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2012-10-26 |