| NPI | 1871846055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENUS LORRAINE GAINES Director Of Nursing 623-486-1510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2013-04-04 |