| NPI | 1891853446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL POWELL Revenue Cycle Director 623-583-3001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2023-04-28 |