| NPI | 1184773889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MCNEAL Administrator 623-435-7279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AZ bh1737) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |