| NPI | 1962375717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIE TOWSON Facilitor 602-473-1286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2025-09-27 |
| Last Update Date | 2025-11-17 |