| NPI | 1972985547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS CARSON Provider Network Management Assoc 602-416-7647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: AZ OTC7440) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2025-08-26 |