NPI | 1609423862 |
---|---|
Entity Type | Organization |
Authorized Contact | OMOBOWALE F JARROW CEO 225-612-8656 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2019-08-22 |
Last Update Date | 2025-02-25 |