| NPI | 1407499593 |
|---|---|
| Doing Business As | NANCY VANVESSEM CENTER FOR HEALTHY AGING |
| Entity Type | Organization |
| Authorized Contact | ALICIA BANGE Accounting Services Manager 850-383-3585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2019-10-22 |