| NPI | 1043715402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN JOHNSON Asst Dir Of Patient Accounting 872-588-3062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2021-07-01 |