| NPI | 1427897628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE EMILY ETOTY Program Dirtector 220-221-7818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WC1500X Registered Nurse Community Health |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-05-20 |