| NPI | 1639618937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT MONTES Registered Agent 908-303-3911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: FL L15000171138) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-02-20 |