| NPI | 1871195875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA MINOR Contracts & Credentialing Spec. 480-969-4024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-11-13 |
| Last Update Date | 2020-11-13 |