| NPI | 1861816357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI SOWARDS FALLAS Clinical Supervisor 480-646-9029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2014-02-05 |