| NPI | 1336714708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADETOMIWA I OGUNDERE CEO 469-363-1058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 251E00000X Home Health |
| 251F00000X Home Infusion | |
| 251J00000X Nursing Care | |
| 251K00000X Public Health or Welfare | |
| 251V00000X Voluntary or Charitable | |
| 252Y00000X Early Intervention Provider Agency | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QR0800X Clinic/Center, Recovery Care | |
| 261QR1300X Clinic/Center, Rural Health | |
| 302R00000X Health Maintenance Organization | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2021-05-26 |