| NPI | 1922300110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY TAYLOR Director 928-445-0744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ 3465) |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2010-11-22 |