| NPI | 1073496055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAFE NELSON HARRIS Medical Director 480-204-0550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2025-07-28 |
| Last Update Date | 2025-07-28 |