| NPI | 1790249837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CECILIA CRUCE Revenue Cycle Specialist 520-309-2718 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2019-01-23 |