| NPI | 1902602923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE MARDULA Partner/Provider 623-606-7994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2025-02-20 |
| Last Update Date | 2025-02-20 |