| NPI | 1699521864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEVONE PHINNESSEE President 833-443-8336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 251E00000X Home Health |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2024-04-27 |
| Last Update Date | 2024-04-27 |