NPI | 1801547468 |
---|---|
Entity Type | Organization |
Authorized Contact | AARON DAVID HALLSTROM Owner 480-360-2172 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2022-01-14 |
Last Update Date | 2024-06-24 |