| NPI | 1790309896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN SILLANPAA Owner 480-525-0058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2024-10-11 |