| NPI | 1376163824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMITT MICHAEL THOMPSON Chief Medical Officer 602-524-7684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 251E00000X Home Health |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2400X Clinic/Center, Prison Health | |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2020-05-22 |