| NPI | 1801207642 |
|---|---|
| Doing Business As | CODAC AT BROADWAY |
| Entity Type | Organization |
| Authorized Contact | DENNIS REGNIER CEO 520-327-4505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2015-09-25 |