| NPI | 1023358660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON SNELL Owner 334-300-9618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: AL 9116005205) |
| Enumeration Date | 2013-02-19 |
| Last Update Date | 2013-08-29 |