| NPI | 1972979862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID SANCHEZ Executive Director 928-515-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: AZ OTC7200) |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2016-10-27 |