| NPI | 1821563586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKY PREMPEH Chief Operating Officer/Administrat 602-332-6699 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2018-10-09 |