| NPI | 1932858081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON DAVID HALLSTROM Co Owner 480-256-8566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2024-10-16 |