| NPI | 1598590291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYDUNG THI PHAN CFO 623-624-5207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133N00000X Nutritionist |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 305S00000X Point of Service | |
| 347C00000X Private Vehicle | |
| 347E00000X Transportation Broker | |
| 133NN1002X Nutritionist Nutrition, Education | |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2024-11-12 |