| NPI | 1124790944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE S AVILES President 939-274-7336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0005X Clinic/Center, Ambulatory Family Planning Facility |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| 253Z00000X In Home Supportive Care | |
| 251E00000X Home Health | |
| 261QE0002X Clinic/Center, Emergency Care | |
| 261QF0050X Clinic/Center, Family Planning, Non-Surgical | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2021-09-30 |