| NPI | 1114465101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE I RICHARDSON Executive Director 602-265-2524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2018-03-21 |