| NPI | 1770955338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC MARINELLI Account Manager 928-642-3030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: AZ OTC 7348) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2022-03-14 |