| NPI | 1063047587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAVON PARKER CEO 267-516-8048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QI0500X Clinic/Center, Infusion Therapy |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2020-03-04 |