| NPI | 1093369597 |
|---|---|
| Doing Business As | PASSPORT HEALTH |
| Entity Type | Organization |
| Authorized Contact | DOUG SHACKELL Director Of Finance 480-646-9024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2019-08-01 |