| NPI | 1669233284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIANE PARKER Cno 740-994-1811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251B00000X Case Management |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2024-01-22 |