| NPI | 1083166136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL RAZZO Chief Executive Officer 928-634-2236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: AZ 261QM0801X) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2016-10-25 |