| NPI | 1629465299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANIS MANALANG Owner 571-313-8750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: FL MH 9217) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2015-04-22 |