| NPI | 1043067655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAJR KHOKHAR Practice Manager 667-802-0425 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2024-05-01 |
| Last Update Date | 2024-05-01 |