| NPI | 1023409760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAURICETTE MONTREDON Chief Executive Officer 520-628-7871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: AZ OTC0037) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2019-12-11 |