| NPI | 1104453208 |
|---|---|
| Other Name | TIDALHEALTH COMMUNITY WELLNESS |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE GARY CFO 410-912-6059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2024-03-05 |