| NPI | 1659308989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILLIE HOLLIDAY Chief Operating Officer 480-983-0065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 103T00000X Psychologist | |
| 251S00000X | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2023-03-23 |