| NPI | 1104442698 |
|---|---|
| Former Legal Business Name | VIP STARNETWORK, LLC |
| Entity Type | Organization |
| Authorized Contact | JOHONNIUSS H CHEMWENO CEO 505-389-2279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based |
| 251K00000X Public Health or Welfare | |
| 251X00000X | |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2020-06-19 |