| NPI | 1518546548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW NAGELBUSH CEO 623-205-3445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202K00000X |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QP0904X Clinic/Center, Public Health, Federal | |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2021-04-06 |