| NPI | 1194335802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRE DREVAL Managing Member 602-400-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 207K00000X Allergy & Immunology |
| 207RP1001X Internal Medicine Pulmonary Disease | |
| 261Q00000X Clinic/Center | |
| 261QI0500X Clinic/Center Infusion Therapy | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2020-08-23 |