| NPI | 1104542679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN CHARLES RAGER BOHRER Owner/Operator 951-404-4380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2026-03-02 |