| NPI | 1962749499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARON JACK Interim CEO 602-404-1555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH4146) |
| Enumeration Date | 2013-01-03 |
| Last Update Date | 2013-01-03 |