| NPI | 1003309238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH RODRIGUEZ Assistant CFO 520-876-1848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: AZ OTC8980) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AZ BH5457) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2023-06-01 |