| NPI | 1801391800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATRICE SHANNON HICKMAN Director Of Prgrm. Dvlpmt. 602-254-7328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ CSLG6804) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2018-03-29 |