| NPI | 1164055596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN H ANDREWS CFO 602-357-4727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-02-13 |
| Last Update Date | 2020-02-13 |