| NPI | 1669992780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JA'MAL TITUS Owner/CEO 225-802-6914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2019-05-09 |