| NPI | 1770934366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HIRAM KEITH BONNER CEO 346-901-3607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2016-06-25 |
| Last Update Date | 2018-12-13 |