| NPI | 1104112655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE K. SIYUJA Health Coordinator 928-448-2821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: AZ 172V00000X) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2011-06-23 |