NPI | 1417331711 |
---|---|
Entity Type | Organization |
Authorized Contact | JONATHAN P MELK CEO 520-364-1429 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: AZ OTC7227) |
Enumeration Date | 2015-07-16 |
Last Update Date | 2021-09-01 |