Directly Affected

NPI #1124603394 in Mesa, Arizona

Provider Information

NPI Number
1124603394
Entity Type
Organization
Organization Name
Directly Affected
Primary Specialty
Clinic/Center - Adolescent and Children Mental Health
Enumeration Date
Mar 10, 2021
Last Updated
Mar 10, 2021

Practice Location

Address
2522 S TERRIPIN
City
Mesa
State
Arizona
ZIP Code
85209-4959
Phone
(614) 980-2116

Authorized Official

Name
DOMINIQUE MYRICK
Title
PRESIDENT
Phone
(614) 980-2116

Specialties & Taxonomy Codes

Specialty
Counselor - Addiction (Substance Use Disorder)Addiction (Substance Use Disorder)
Case Management
Community/Behavioral Health
Foster Care Agency
Clinic/Center - Adolescent and Children Mental HealthAdolescent and Children Mental Health

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