| NPI | 1205426053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IMMA NZOMO Administrator 480-608-4877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QP2300X Clinic/Center, Primary Care | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2021-01-25 |
| Last Update Date | 2023-07-26 |