| NPI | 1255577789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY NEWSOME Director 704-713-4618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NC 60002779) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: NC 60002779) |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2009-01-06 |