Organization
ARIZONA STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL YOUNGER MHA FACHE (MANAGER NP HEALTHCARE)
(602) 496-0721
Entity
Organization
Contact information
Practice address
500 N 3RD ST, PHOENIX, AZ 85004-2135
(602) 496-0721
Mailing address
500 N 3RD ST, PHOENIX, AZ 85004-2135
(602) 496-0721
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
AP4432
AZ
Other
Enumeration date
04/10/2012
Last updated
04/10/2012
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