| NPI | 1043089998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORA AGYEI AGYEMANG Owner 912-800-9220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251E00000X Home Health | |
| 261Q00000X Clinic/Center | |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 261QR1300X Clinic/Center, Rural Health | |
| Enumeration Date | 2023-12-20 |
| Last Update Date | 2023-12-20 |