| NPI | 1790466035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALLAN DEPRIEST Director 480-382-6982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| 208D00000X General Practice | |
| Enumeration Date | 2023-07-28 |
| Last Update Date | 2025-10-16 |