| NPI | 1508323254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARZENA FERCZ Chief Compliance Officer 888-703-6999 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2025-12-03 |