| NPI | 1821341207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSH LANNON CEO 480-840-2588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: AZ BH4054) |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2012-10-22 |