Organization
SAN LUIS WALK-IN CLINIC, INC.
Active
Parent organization
SAN LUIS WALK-IN CLINIC, INC.
Other names
Lake Havasu Pediatric Family Clinic - Mobile Unit
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAN LUIS WALK-IN CLINIC, INC.
Authorized official
AMANDA AGUIRRE (PRESIDENT & CEO)
(928) 315-7910
Entity
Organization
Contact information
Practice address
1940 MESQUITE AVE, LAKE HAVASU CITY, AZ 86403-6123
(928) 459-3512
(928) 459-3514
Mailing address
PO BOX 617, SOMERTON, AZ 85350-0617
(928) 315-7910
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
08/09/2022
Last updated
09/07/2023
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