| NPI | 1275322604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL KODICEK Specialized Services Supervisor 480-662-5475 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Enumeration Date | 2025-05-02 |
| Last Update Date | 2025-05-02 |