| NPI | 1467685958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD J HARRIS General Manager 928-941-4409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: AZ 1962341) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2009-08-31 |