| NPI | 1548147226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RODRIGUES Director 877-404-1271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 261QP0905X Clinic/Center, Public Health, State or Local |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2025-08-16 |
| Last Update Date | 2025-08-16 |