| NPI | 1609179746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALRENEASE COOK Owner 662-274-0458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: TN 160706) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: TN 160706) |
| Enumeration Date | 2010-12-12 |
| Last Update Date | 2010-12-12 |