| NPI | 1972968360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON REARDON Chief Executive Officer 520-407-5609 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: AZ 6491) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2025-06-20 |