| NPI | 1952948804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ELLERT Cmo 602-776-0776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2024-10-10 |