| NPI | 1083362842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE STELLBAUER CFO 678-347-2153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 163WI0500X Registered Nurse Infusion Therapy | |
| 164W00000X Licensed Practical Nurse | |
| 207RI0200X Internal Medicine Infectious Disease | |
| 261QI0500X Clinic/Center Infusion Therapy | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-03-11 |
| Last Update Date | 2022-03-11 |