| NPI | 1578432118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIAJANNAE WILSON Administrator 562-725-0889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-11-03 |
| Last Update Date | 2025-11-03 |