| NPI | 1912164039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY B. HENNING CEO 602-285-4340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AZ OTC6612) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 251B00000X Case Management (Licence: AZ OTC6612) | |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2025-02-18 |