| NPI | 1134980436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIANE PARKER Cno 740-994-1811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-01-23 |