| NPI | 1427922871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA ELIZABETH DALTON Chief Medical Operating Officer 877-855-7526 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2025-09-30 |
| Last Update Date | 2025-09-30 |