| NPI | 1609006105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REV. GOLDIE N. WESTLEY Associate Minister 281-493-1883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2009-07-17 |