| NPI | 1811681695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUACY R MANNING CEO 480-300-4651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2023-08-19 |