| NPI | 1881737849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANDREW LAZARE Member Manager 602-224-7051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0002X Clinic/Center, Emergency Care (Licence: AZ BH 3143) |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation (Licence: AZ BH 3143) |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: AZ BH 3143) | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2008-10-31 |