| NPI | 1528653995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAZAD ASHRAF BUKSH CEO 833-469-2692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
| 261QR0400X Clinic/Center, Rehabilitation | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 261QD0000X Clinic/Center, Dental | |
| 261QR0800X Clinic/Center, Recovery Care | |
| 261QH0100X Clinic/Center, Health Services | |
| 251E00000X Home Health | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2021-03-07 |
| Last Update Date | 2023-03-05 |