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 |