| NPI | 1801365846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DYNA HAUGEN CFO 480-250-5807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 101YM0800X Counselor Mental Health | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 103TP2701X Psychologist Group Psychotherapy | |
| 1041C0700X Social Worker Clinical | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2019-08-19 |