| NPI | 1891104691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER LYNN Owner 602-774-0878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2023-07-06 |