| NPI | 1972205987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK REIGELSPERGER Owner 602-622-7731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0801X |
| 261QP2300X Clinic/Center, Primary Care | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2023-03-21 |
| Last Update Date | 2023-10-30 |