| NPI | 1184218935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIELS DUTCH ROJAS Owner 602-777-0101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2021-02-23 |
| Last Update Date | 2021-02-23 |