| NPI | 1912654476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY BARRASSO COO 520-722-9631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2022-03-04 |
| Last Update Date | 2023-07-28 |