| NPI | 1588424311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCIUS KING Director 602-579-2227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2025-03-06 |