| NPI | 1619430733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AKILAH BELLINGER Director Of Clinical Services 689-331-8352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2025-08-06 |