| NPI | 1295108140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRESTRE MERITA BODDY CEO 770-310-3257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: GA 15015001) |
| Enumeration Date | 2015-10-31 |
| Last Update Date | 2015-10-31 |