| NPI | 1215319249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY GUSTAFSON Chief Executive Officer 855-392-6411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0208X Clinic/Center, Radiology, Mobile (Licence: CA 1578548822) |
| Additional Taxonomies | 332U00000X Home Delivered Meals |
| 261QH0100X Clinic/Center, Health Services | |
| 261QR1300X Clinic/Center, Rural Health (Licence: CA 1578548822) | |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2016-01-19 |