| NPI | 1396337689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMEELAH ANDERSON Owner 762-524-2410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 251J00000X Nursing Care |
| 251S00000X | |
| 252Y00000X Early Intervention Provider Agency | |
| 302R00000X Health Maintenance Organization | |
| 305S00000X Point of Service | |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2021-02-08 |