| NPI | 1831832179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA BAZEMORE QUAYE Clinical Director 602-509-2677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2025-04-04 |