| NPI | 1659257301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE SANCHEZ Director 833-753-5589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 251E00000X Home Health |
| 261Q00000X Clinic/Center | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 291U00000X Clinical Medical Laboratory | |
| 302R00000X Health Maintenance Organization | |
| 305R00000X Preferred Provider Organization | |
| Enumeration Date | 2025-08-15 |
| Last Update Date | 2025-08-15 |