| NPI | 1932588795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ELLERT Chief Medical 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 | 2024-10-10 |