NPI | 1174052799 |
---|---|
Entity Type | Organization |
Authorized Contact | PEGGY J BRADLEY Owner 623-999-2273 |
Organization Subpart ? | No |
Primary Taxonomy | 251E00000X Home Health |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2017-06-07 |
Last Update Date | 2022-07-21 |