| NPI | 1912177254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLINTON KUNTZ CEO 520-309-2012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: AZ OTC0006) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2023-03-02 |