| NPI | 1851711840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS A GROSSMAN Administrative Director 602-410-6635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ OTC5871) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2022-08-11 |