| NPI | 1275111767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICK MERINO PAYAN Director 928-388-3793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Additional Taxonomies | 251B00000X Case Management |
| 302R00000X Health Maintenance Organization | |
| 305S00000X Point of Service | |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2021-03-29 |