| NPI | 1922995877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY E EMERT CFO 602-980-3862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2025-06-23 |
| Last Update Date | 2026-06-11 |