| NPI | 1336262682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL LEDSEMA Medical Director 602-996-8327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: AZ 21110) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2012-12-03 |