| NPI | 1366846917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLINTON KUNTZ CEO 520-670-3909 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: AZ OTC0006) |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2023-01-24 |