| NPI | 1679941447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOUSSAM ELCHEKHA Owner 573-639-0256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: WI 7001-15) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2015-09-09 |