| NPI | 1164119442 |
|---|---|
| Doing Business As | TRUE VINE HEALTH LLC |
| Former Legal Business Name | TRUE VINE HEALTH LLC |
| Entity Type | Organization |
| Authorized Contact | MARCUS MOTTON Program Director 667-600-9450 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-04-18 |