| NPI | 1598052466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN PAUL NESTOR Site Director 928-428-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health (Licence: AZ 3915) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2011-07-07 |