| NPI | 1073091328 |
|---|---|
| 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 OTC7290) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2020-07-15 |