NPI | 1891172052 |
---|---|
Entity Type | Organization |
Authorized Contact | DEMETRIA (MIMI) CHARMAINE HARRIS CEO 480-207-7560 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: AZ OTC6493) |
Enumeration Date | 2015-04-27 |
Last Update Date | 2015-04-27 |