| NPI | 1144343724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAPETA B MAYSON Interim Chief Executive Officer 267-541-9204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: PA 104560) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2024-10-29 |