| NPI | 1215921457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIERDRA YOUNG Director 267-426-5722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282NC2000X General Acute Care Hospital, Children |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | |
| 282N00000X General Acute Care Hospital | |
| 283XC2000X Rehabilitation Hospital, Children | |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2023-06-13 |