| NPI | 1548694961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA DALY LITTLEFIELD Owner/ CEO 855-454-3784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: CA ota 2205) |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2020-01-29 |