| NPI | 1285647263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARA GOUVEIA Vice President Of Operations 520-261-4347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251S00000X (Licence: PA 325980) |
| 251S00000X (Licence: PA 137430) | |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2025-03-04 |