| NPI | 1871672873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIGID WAGNER Programs Director 928-607-3527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH1013) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2025-01-28 |