NPI | 1790487353 |
---|---|
Entity Type | Organization |
Authorized Contact | JANOZZLE WRIGHT Authorized Agent 602-803-2065 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 251S00000X |
Enumeration Date | 2023-03-20 |
Last Update Date | 2023-03-20 |