| NPI | 1699136713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHELLE MANGIN RN 984-289-7680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NC 206929) |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2016-03-17 |