| NPI | 1760789457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA JO HALTERMAN President 928-606-6007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ lac 12862) |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2011-02-16 |