NPI | 1548210461 |
---|---|
Entity Type | Organization |
Authorized Contact | JON REARDON Chief Executive Officer 520-407-5609 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: AZ OTC-3915) |
Enumeration Date | 2006-05-11 |
Last Update Date | 2025-06-20 |