| NPI | 1902141518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORINA OGAZ Associate Director, Credentialing 602-636-3085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2012-12-07 |
| Last Update Date | 2022-06-21 |