| NPI | 1770209488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE ROBINSON Administrator 602-322-7031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QP2300X Clinic/Center, Primary Care | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2022-10-14 |
| Last Update Date | 2025-04-19 |