| NPI | 1609284801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK CASALE President 623-594-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: AZ 8110) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2014-07-31 |