| NPI | 1013547686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAINE BANDI CEO 602-368-9616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2021-04-09 |