| NPI | 1568223279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN GODFREY COO 602-688-0350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2024-01-19 |
| Last Update Date | 2024-07-15 |