| NPI | 1780420851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HYLEIA S KIDD Chief Operations Officer 602-921-4094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-07-08 |
| Last Update Date | 2024-07-08 |