| NPI | 1487340535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN LEE KELLEY Manager / CEO 501-804-9298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2023-04-12 |