NPI | 1568021772 |
---|---|
Other Name | LA AMISTAD MOBILE MEDICAL |
Entity Type | Organization |
Authorized Contact | TIMOTHY JASON BROWN Chief Executive Officer 208-899-9631 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2019-06-11 |
Last Update Date | 2023-10-23 |