| NPI | 1215280920 |
|---|---|
| Other Name | COPPERMINE CHAPTER HOUSE |
| Entity Type | Organization |
| Authorized Contact | JOSEPH T ENGELKEN CEO 928-283-2501 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2012-10-24 |