NPI | 1275392573 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA ANDERSON President 855-380-6136 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
Enumeration Date | 2024-03-18 |
Last Update Date | 2024-10-03 |