| NPI | 1699126342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNITA MOLINA Owner/Director 314-791-9390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MO lc9806604) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |