| NPI | 1871987495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR H WOOD Executive Director 928-445-0778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: AZ OTC 7091) |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2021-08-18 |