| NPI | 1497032460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA B CARZOLI CEO 520-682-4111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: AZ OTC5209) |
| Additional Taxonomies | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-11-04 |
| Last Update Date | 2024-05-06 |