| NPI | 1295758159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RITA D ROGERS Manager 3134-239-3164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MI 4301028439) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-08-22 |