| NPI | 1588315550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY GERI BROWN Owner 267-536-9188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251J00000X Nursing Care |
| 251K00000X Public Health or Welfare | |
| 305S00000X Point of Service | |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2023-07-17 |