| NPI | 1891913166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS ROBINETTE CEO 520-836-3346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: AZ 0703419) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2017-08-03 |