| NPI | 1205078045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEZLEY O'BRIEN Lpn 623-691-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AZ LP039215) |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2009-03-25 |