| NPI | 1184102709 |
|---|---|
| Other Name | EXTENSION SABG |
| Entity Type | Organization |
| Authorized Contact | CHRIS RILEY Compliance Officer 602-263-5242 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: AZ BH-5467) |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2023-12-27 |