| NPI | 1114687175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL MONET DURANT CFO 562-760-3983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2021-12-17 |
| Last Update Date | 2021-12-17 |