| NPI | 1891307328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LELOOLE BARIKA Admin 480-635-6712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 251S00000X | |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2020-08-17 |