| NPI | 1801644521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUC-ARMAND NINGUMIRIZE Member 480-276-0689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-05-08 |
| Last Update Date | 2025-05-07 |