| NPI | 1003519273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKIEL THOMAS Owner 225-475-0009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172A00000X Driver |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2023-03-24 |