| NPI | 1023073525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY HADEN CEO 520-508-7829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2025-05-07 |