| NPI | 1619172467 |
|---|---|
| Doing Business As | DETAR SENIOR CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | DEBBIE BREWER Director Of Provider Enrollment 877-892-9813 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2011-06-30 |