| NPI | 1851895783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CLARK BRUBAKER Owner 520-836-9788 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ LISACAZ0122) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-03-23 |