| NPI | 1588092613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMELIA ORUBELE Owner 678-879-0721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: GA 302r00000x) |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |