| NPI | 1558655175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNDIATA CHAKA KEITAZULU Sales Manager 203-654-5187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CT hcaoooo492) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: CT hca0000492) |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2011-05-31 |