NPI | 1104116029 |
---|---|
Doing Business As | EL PUEBLO HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | CLINTON KUNTZ CEO 520-309-2012 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: AZ OTC3984) |
Enumeration Date | 2011-04-12 |
Last Update Date | 2023-03-02 |