NPI | 1619276466 |
---|---|
Entity Type | Organization |
Authorized Contact | FRANCIS DEKU President 817-226-8759 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX 00966) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: TX 00966) |
Enumeration Date | 2011-03-18 |
Last Update Date | 2011-03-30 |