| NPI | 1548836844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEWANNA WILSON Provider 404-645-2960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251J00000X Nursing Care |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2021-05-28 |
| Last Update Date | 2024-11-12 |