| NPI | 1851830582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI LYNN SIECZKOWSKI Owner 480-630-0613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ LCSW10655) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2019-07-08 |