| NPI | 1659823425 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | SHIJUN LI Owner 678-273-2472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2022-07-21 |