| NPI | 1922718196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY JEPTOO BETT Owner 602-708-9253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 363L00000X Nurse Practitioner | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2022-11-29 |
| Last Update Date | 2023-06-30 |