| NPI | 1356182901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAYE ZENGBEAN COO 424-394-5554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 335G00000X Medical Foods Supplier | |
| Enumeration Date | 2024-06-05 |
| Last Update Date | 2024-06-05 |