| NPI | 1407174717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE BOONE C,E.O 862-403-9118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: VA 1687) |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2024-06-24 |