| NPI | 1659359131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES PATTERSON WEISS Health Services Technician 757-483-8597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2020-08-22 |