| NPI | 1376027193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EILEEN TOSOLINI Provider Relations Manager 321-397-5251 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2021-08-04 |