| NPI | 1710776133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LADONNA BALLARD Regional Services Manager 602-291-4414 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Enumeration Date | 2025-05-02 |
| Last Update Date | 2025-05-02 |