| NPI | 1053197251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELVIN DAM Manager 816-867-0867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335G00000X Medical Foods Supplier |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 172V00000X Community Health Worker | |
| 251K00000X Public Health or Welfare | |
| Enumeration Date | 2023-09-04 |
| Last Update Date | 2023-09-04 |