| NPI | 1801226303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW AARON BURGESS Administrative Specialist 928-919-2373 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH4399) |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2013-11-19 |