| NPI | 1891534418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEJANDRA G VILCHIS Cred Manager 602-248-8886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 251S00000X Community/Behavioral Health | |
| 261QM2800X Clinic/Center Methadone | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2024-05-22 |
| Last Update Date | 2024-05-22 |