| NPI | 1386399780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVETTE RIVERA Revenue Cycle Manager 866-950-8013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2022-02-15 |