| NPI | 1528342490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNELL BALDWIN Community Mentor 702-797-0546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NV 2600399991) |
| Enumeration Date | 2011-10-10 |
| Last Update Date | 2011-10-10 |