| NPI | 1912209859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM LACEY CEO/Administrator 520-417-2115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH-3732) |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2010-11-29 |