| NPI | 1851413009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MINDI A WOODRUFF Acting Secretary/Program Sponsor 480-981-1022 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ BH957) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2019-12-12 |