| NPI | 1548210461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODOLFO JIMENEZ CEO 520-407-5600 |
| 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 | 2016-07-15 |