| NPI | 1457841678 |
|---|---|
| Other Name | DESERT PALM MAT |
| Entity Type | Organization |
| Authorized Contact | ROSE MARY LOPEZ President And CEO 520-721-1887 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: AZ Pending) |
| Additional Taxonomies | 261Q00000X |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2020-04-20 |