| NPI | 1861118663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRE NICHOLAS MILLER Administrator 480-980-0648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-10-13 |
| Last Update Date | 2022-10-13 |