| NPI | 1811417397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY GAITHER VP Revenue Cycle Mgmt 602-248-8886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: TX CFN1000036) |
| Additional Taxonomies | 251S00000X |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2024-02-10 |