Graduated: 2015
NPI: 1124415773
Practice Locations (2)
DHEW IND HLTH SV HLTH SVS AND MNTL HLTH ADM
4212 N 16TH ST
PHOENIX, AZ 850165319
6022631200
GILA RIVER HEALTH CARE CORPORATION
483 W SEED FARM RD, HU HU KAM MEMORIAL HOSP
SACATON, AZ 851470038
6025281200
Source: CMS National Downloadable File, September 2026.