| NPI | 1558142075 |
|---|---|
| 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 | 2023-10-10 |
| Last Update Date | 2023-12-11 |