| NPI | 1912851122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALI PETERSON Executive Director 928-231-4731 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2026-02-24 |
| Last Update Date | 2026-02-24 |