| NPI | 1164995387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMED HARUNA Manager 469-248-2319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2019-07-18 |