| NPI | 1629316567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALENCIA NICHOLAS Hr 267-513-1722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: PA PN279447) |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2013-01-28 |