| NPI | 1841698818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOURTNEY STAFFORD CEO 602-803-3902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ OTC6629) |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2014-12-08 |