| NPI | 1114221645 |
|---|---|
| Doing Business As | MARY'S MISSION OUTPATIENT CLINIC |
| Entity Type | Organization |
| Authorized Contact | WILLIAM LACEY CEO 480-844-0022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AZ BH-3732) |
| Enumeration Date | 2010-12-23 |
| Last Update Date | 2010-12-23 |