| NPI | 1639013535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA LEWIS Director 855-313-0479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 163WH1000X Registered Nurse, Hospice |
| 246W00000X Technician, Cardiology | |
| Enumeration Date | 2026-04-20 |
| Last Update Date | 2026-04-20 |