NPI | 1902661457 |
---|---|
Entity Type | Organization |
Authorized Contact | LAWRENCE THOMAS Administrator 480-490-8803 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
261QM2500X Clinic/Center, Medical Specialty | |
Enumeration Date | 2024-02-14 |
Last Update Date | 2024-11-14 |