| NPI | 1972075844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS JAMES LOSOLE President 480-550-2163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2019-04-29 |