| NPI | 1184385874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERJUAN TOLES Owner 239-595-9040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 171W00000X Contractor | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2022-01-04 |
| Last Update Date | 2022-03-15 |