| NPI | 1043414428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN KAMARA Area Director 1260-347-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: IN 101ym0800x) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2020-08-22 |