NPI | 1932588795 |
---|---|
Entity Type | Organization |
Authorized Contact | BRANDON S CLARK Chief Executive Officer 602-776-0776 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: AZ UNC5520 / MED4983) |
Enumeration Date | 2015-05-27 |
Last Update Date | 2017-11-21 |