| NPI | 1578070447 |
|---|---|
| Doing Business As | CODAC AT ALVERNON |
| Entity Type | Organization |
| Authorized Contact | PAUL AXINN Contracts And Credentialing Manager 520-202-1755 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2018-01-02 |