| NPI | 1841765674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE MARTORI Manager 602-920-4290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2022-02-14 |