| NPI | 1821854712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRSTEN A SORENSEN Administrator 602-388-1180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine |
| Enumeration Date | 2024-02-27 |
| Last Update Date | 2025-01-21 |