| NPI | 1518573096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODERICK MARTIN Managing Member 877-424-4534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2020-09-19 |
| Last Update Date | 2020-09-19 |