| NPI | 1427426204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE MACSHALLE WELLS Certified Diabetes Educator 501-240-3579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: AR 21420274) |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2015-09-10 |