| NPI | 1770651317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRACKIE D SEKAVEC Owner 520-629-9126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ BH1448) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2024-01-23 |