| NPI | 1023630332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANA BERRY Program Manager 972-342-8527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 163W00000X Registered Nurse |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2024-08-27 |