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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MATILDA BOACHIE APRN (CEO/PRESIDENT)
(860) 967-2388
Entity
Organization

Contact information

Practice address
316 W PINNACLE RIDGE DR, SAN TAN VALLEY, AZ 85140-7047
(860) 967-2388
Mailing address
316 W PINNACLE RIDGE DR, SAN TAN VALLEY, AZ 85140-7047
(860) 967-2388

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary

Other

Enumeration date
12/04/2023
Last updated
12/04/2023
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