| NPI | 1891338547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIANA JOY CONDELLO Member 520-548-8974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2019-11-05 |