| NPI | 1821896051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADDISON HOWARD Administrative Officer 928-531-1930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-03-04 |
| Last Update Date | 2025-12-12 |