| NPI | 1306463542 |
|---|---|
| Former Legal Business Name | WELLHAVEN PRIMARY CARE LLC |
| Entity Type | Organization |
| Authorized Contact | JILLION T HARRIS Owner 619-752-2280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-07-04 |
| Last Update Date | 2020-07-04 |