| NPI | 1740501733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER G. MCSHEA Administrator 520-886-7887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: AZ 07568438) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2010-06-14 |