| NPI | 1346659018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARNOLDO PROCELA LOPEZ Chief Executive Officer 520-400-8660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: AZ 12985) |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2014-08-07 |