| NPI | 1831223304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE ELNADRY Owner President 928-329-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AZ 21613) |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health (Licence: AZ 21613) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |