Organization
EMPACT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE BROWN (HR SPECIALIST)
(480) 784-1514
Entity
Organization
Contact information
Practice address
1232 E BROADWAY RD, STE 120, TEMPE, AZ 85282-1511
(480) 784-1514
Mailing address
2671 E MILKY WAY, GILBERT, AZ 85296-9131
(480) 279-6292
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MFT10036
AZ
Other
Enumeration date
12/04/2006
Last updated
08/22/2020
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