| NPI | 1730928953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC ALLAN SHOEMAKER Do 602-660-7802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-05-20 |