| NPI | 1538916853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LYLES Accounts Receivable Director 267-637-4536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2024-05-03 |