| NPI | 1922495977 |
|---|---|
| Former Legal Business Name | DAVID EVAN DEN FOUW |
| Entity Type | Organization |
| Authorized Contact | DAVID EVAN DEN BOER President 602-354-1337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ D07408423) |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2015-04-16 |