| NPI | 1821309089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN P MELK CEO 520-364-6852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2021-09-01 |