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 |