| NPI | 1861099798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENITHO LOUISSAINT Member 480-471-8980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 175T00000X Peer Specialist | |
| 251B00000X Case Management | |
| 251S00000X | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 363LF0000X Nurse Practitioner, Family | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2024-12-13 |