| NPI | 1891345286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRMA LARA CEO 928-782-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2019-09-17 |