| NPI | 1588104863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARNERA BURGESS Owner/Director 267-243-7858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251E00000X Home Health |
| 261QH0100X Clinic/Center Health Service | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |