| NPI | 1114627635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER KOZLOW Authorized Official/Manager 606-691-0366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Enumeration Date | 2023-03-03 |
| Last Update Date | 2023-04-13 |