| NPI | 1821499104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY M BLACK Chief Executive Officer 602-243-1773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ 4868156) |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2014-09-05 |