| NPI | 1073814505 |
|---|---|
| Doing Business As | CELETHIA COLEMAN |
| Entity Type | Organization |
| Authorized Contact | CELETHIA J COLEMAN Cna/Pct 404-823-4481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: GA 812199) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: GA 12053036) |
| Enumeration Date | 2010-11-15 |
| Last Update Date | 2015-01-02 |