| NPI | 1912250119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EZEKIEL JOHNSON Executive Director 480-704-4707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TR0400X Psychologist, Rehabilitation |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 101YM0800X Counselor, Mental Health | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2015-05-07 |