| NPI | 1073100079 |
|---|---|
| Former Legal Business Name | LIMITED LIABILITY COMPANY |
| Entity Type | Organization |
| Authorized Contact | TREMCIA N TAYLOR Owner 866-478-3508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2020-12-23 |
| Last Update Date | 2020-12-23 |