| NPI | 1679195879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY BAKER Member 520-820-3028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2024-06-27 |