| NPI | 1902661457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORRENDA SMITH Director 602-628-0601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-02-14 |
| Last Update Date | 2025-05-15 |